Open heart surgery was the only option available for surgeries such as bypass grafting, heart valve repair or replacement , closure of holes in the heart etc until the advent of minimally invasive cardiac surgery (MICS). MICS or keyhole heart surgery does not require the breast bone to be cut and overcomes the associated problems of pain and slow recovery. Heart attacks are responsible for 14.5% of all deaths in India and MICS CABG or keyhole bypass has emerged as an answer to patients suffering from coronary artery diseases.
What is MICS CABG (Keyhole Bypass) and when is it performed? Coronary Artery Bypass Surgery (CABG) is performed as both open-heart and MICS. This procedure restores the compromised blood supply to the heart caused due to coronary artery disease (CAD). CAD results in blocked blood supply to the heart causing agonizing chest painor angina, heart failure and death.
- Left main coronary artery stenosis >50%
- Multi vessel disease in patients with heart failure or chest pain (angina)
- 1- or 2-vessel disease in high-risk areas in patients unsuitable for balloon angioplasty (PCI). Poor left ventricular function but with viable, nonfunctioning myocardium
● ST-segment elevation MI (STEMI) in cases where it has not been possible to perform percutaneous coronary intervention (PCI) or where PCI has failed and there is persistent pain and ischemia threatening a significant area of myocardium despite medical therapy.
Who is suitable for MICS CABG?
Nearly 80% of patients who require a bypass surgery or CABG are suitable for MICS CABG, thereby reducing the need for conventional open heart surgery.
5 step of MICS CABG
- A small cut on the left side of the chest is placed just under the nipple.
- The chest is entered between the ribs without cutting any bones and by splitting the muscle.
- The bypass surgery is performed using all arteries or a combination of arteries and veins removed from the leg.
- The vessel from the leg in this operation is also removed endoscopically (EVH or endoscopic vein harvesting) without cutting the skin over the leg.
- Highly advanced instrumentation and advanced techniques allow for the operation to be performed very safely.
We routinely perform as many as 5 bypasses in MICS CABGs including right sided vessels. We have the largest experience in the world with these operations and perform these operations everyday. Our experience allows us to bypass all vessels of the heart including right sided vessels that other institutions are unable to do.
Keyhole surgery is miles ahead in heart surgeries and clearly differentiates itself through:
- No bones are cut- reducing pain and sufferings
- Minimising loss of blood during surgery – decreasing the need for blood transfusion
- Small cuts mean near zero infection rates – therefore ideal for both diabetics and non diabetics
- Heals with a cosmetic scar
- Shortens hospital stay, ICU stay and time on breathing machine
- Early recovery allows you to resume normal activities within 10 days
- Reduced hospital stay
- Reduced chances of infection
- No restriction in lifting weights or driving a car or travelling
Approximately, 90,000 CABGs are performed yearly in India, with 99% success rates. Apollo Hospitals perform the highest number of heart surgeries and minimally invasive heart surgeries in India, pioneering MICS through highly skilled professional with technology offering unmatched patient outcomes. “MICS is the future of heart surgery. It’s safe, effective and delivers outstanding patient comfort and outcomes. It’s the best thing to happen to heart surgery in the last two decades”
Article by :
Dr Sathyaki P Nambala
Cardio Thoracic Surgeon